Siegel, Gordon J

Siegel, Gordon J is an individual health care provider with primary practice located at 3 E Huron St Fl 1, Chicago IL 60611-2887. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck, which is considered as his primary health care specialty. Siegel, Gordon J can be contacted via phone (312) 988-7777.

Contact Information

Primary practice address
3 E Huron St Fl 1 Chicago IL 60611-2887
Phone: (312) 988-7777
Fax: (312) 988-7838
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X 036053430 Illinois

Profile Details

NPI number 1982609103
LBN Legal business name Siegel, Gordon J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Jan 31st, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982609103 NPPES
Illinois MEDICAID 036059430

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